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Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study.

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Title: Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study.
Authors: Hu, Jie (AUTHOR), Kline, David M (AUTHOR), Tan, Alai (AUTHOR), Zhao, Songzhu (AUTHOR), Brock, Guy (AUTHOR), Mion, Lorraine C (AUTHOR), Efird, Jimmy T (AUTHOR), Wang, Danxin (AUTHOR), Sims, Mario (AUTHOR), Wu, Bei (AUTHOR), Mongraw-Chaffin, Morgana (AUTHOR), Joseph, Joshua J (AUTHOR)
Source: Annals of Behavioral Medicine. Dec2022, Vol. 56 Issue 12, p1300-1311. 12p.
Subjects: World Health Organization, Social determinants of health, Type 2 diabetes, Glycemic control, African Americans, Americans
Abstract: Background: Social determinants of health have a significant impact on health outcomes. However, the complexity and interaction of multiple factors influencing glycemic control remain understudied.Purpose: This study examined associations of socioeconomic position (income, education, and occupation), environmental (physical activity facilities, neighborhood social cohesion, neighborhood problem, and violence), behavioral (physical activity, nutrition, and smoking), and psychological factors (depressive symptoms, stress, and discrimination) with glycemic control (hemoglobin A1c [A1c]) using the World Health Organization Social Determinants of Health framework in African American adults with type 2 diabetes.Methods: A secondary data analysis was conducted using a longitudinal cohort of 1,240 African American adults with type 2 diabetes who participated in the community-based Jackson Heart Study. Socioeconomic position, environmental, behavioral, and psychological factors were measured using validated instruments in the Jackson Heart Study. Longitudinal structural equation modeling was used with glycemic control (A1c) collected over time (Exams 1-3) as the study outcome.Results: Our study presents the complex interplay of socioeconomic determinants of health and glycemic control over time. Higher socioeconomic position (higher income, higher level of education, and professional occupation) was directly associated with improvement in glycemic control over time. An association of socioeconomic position on glycemic control mediated through health behavior factors was also observed.Conclusions: In this analysis, socioeconomic position components were determinants of glycemic control in African American adults with type 2 diabetes. Future studies aimed at reducing health disparities and achieving equality of outcomes in this population will benefit from embedding socioeconomic position components into their design. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Behavioral Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Association Between Social Determinants of Health and Glycemic Control Among African American People with Type 2 diabetes: The Jackson Heart Study.
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  Data: <searchLink fieldCode="JN" term="%22Annals+of+Behavioral+Medicine%22">Annals of Behavioral Medicine</searchLink>. Dec2022, Vol. 56 Issue 12, p1300-1311. 12p.
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  Data: <searchLink fieldCode="DE" term="%22World+Health+Organization%22">World Health Organization</searchLink><br /><searchLink fieldCode="DE" term="%22Social+determinants+of+health%22">Social determinants of health</searchLink><br /><searchLink fieldCode="DE" term="%22Type+2+diabetes%22">Type 2 diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22Glycemic+control%22">Glycemic control</searchLink><br /><searchLink fieldCode="DE" term="%22African+Americans%22">African Americans</searchLink><br /><searchLink fieldCode="DE" term="%22Americans%22">Americans</searchLink>
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  Data: <bold>Background: </bold>Social determinants of health have a significant impact on health outcomes. However, the complexity and interaction of multiple factors influencing glycemic control remain understudied.<bold>Purpose: </bold>This study examined associations of socioeconomic position (income, education, and occupation), environmental (physical activity facilities, neighborhood social cohesion, neighborhood problem, and violence), behavioral (physical activity, nutrition, and smoking), and psychological factors (depressive symptoms, stress, and discrimination) with glycemic control (hemoglobin A1c [A1c]) using the World Health Organization Social Determinants of Health framework in African American adults with type 2 diabetes.<bold>Methods: </bold>A secondary data analysis was conducted using a longitudinal cohort of 1,240 African American adults with type 2 diabetes who participated in the community-based Jackson Heart Study. Socioeconomic position, environmental, behavioral, and psychological factors were measured using validated instruments in the Jackson Heart Study. Longitudinal structural equation modeling was used with glycemic control (A1c) collected over time (Exams 1-3) as the study outcome.<bold>Results: </bold>Our study presents the complex interplay of socioeconomic determinants of health and glycemic control over time. Higher socioeconomic position (higher income, higher level of education, and professional occupation) was directly associated with improvement in glycemic control over time. An association of socioeconomic position on glycemic control mediated through health behavior factors was also observed.<bold>Conclusions: </bold>In this analysis, socioeconomic position components were determinants of glycemic control in African American adults with type 2 diabetes. Future studies aimed at reducing health disparities and achieving equality of outcomes in this population will benefit from embedding socioeconomic position components into their design. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Annals of Behavioral Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1093/abm/kaac026
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        Type: general
      – SubjectFull: Social determinants of health
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      – SubjectFull: Type 2 diabetes
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      – SubjectFull: Glycemic control
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      – SubjectFull: African Americans
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              Text: Dec2022
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